Medically reviewed by Mary Lucas, RN
Written by Our Editorial Team
Last updated 6/21/2020
When you have a headache, you probably don’t think twice about taking a Tylenol® or other medication to feel better. But things like depression and anxiety often come with more stigma than a headache.
And in the same way that ibuprofen or acetaminophen work to help with your headache, healthcare professionals will sometimes prescribe other drugs to help with issues like depression, anxiety and other mood disorders.
SSRIs are one type of those drugs.
But what are SSRIs? How do they work? What are their side effects and should you be worried about taking them with other medications?
Doing your research before pursuing any medical treatment is wise. Get the basics below, then talk to your healthcare provider about whether SSRIs might be right for you.
SSRI stands for selective serotonin reuptake inhibitor. SSRIs are a type of prescription drug used primarily to treat depression, but are also used in the treatment of anxiety, obsessive compulsive disorder, panic disorders, phobias, post-traumatic stress disorder (PTSD) and eating disorders.
SSRIs work by inhibiting (blocking) serotonin reabsorption, or by freeing up more serotonin in the brain. Because serotonin is a neurotransmitter that influences mood, emotions and sleep, SSRIs are able to influence these things as well.
The first of these drugs — fluoxetine — was introduced in the U.S. in 1987 and, at the time, was seen as an effective alternative to existing antidepressants, with fewer side effects.
Compared to other types of antidepressants, SSRIs generally have fewer side effects while also maintaining their effectiveness. Because SSRIs are typically better tolerated and offer less risk of experiencing side effects, some studies have even shown that fewer patients discontinue SSRI therapy than with alternative antidepressants.
That said, SSRIs aren’t completely without side effects. SSRIs may cause insomnia, joint and muscle pain, digestive distress, reduced interest in sex, problems ejaculating and reduced sexual satisfaction overall.
These side effects can be minimized by starting with a low dosage and moving up gradually, so you’re not taking any more than necessary.
There are several different SSRIs, sold under both brand names and generic labels. They all work to impact serotonin in the brain, though there are generally-subtle differences between them.
Some of the more commonly prescribed SSRIs include:
While all of the above drugs work in largely the same way, there are some differences between them. Dosages vary from one SSRI to the next, and so can side effects or the potential for drug interactions, for example. Here are how some of these medications stand out from one another:
Escitalopram. Some research indicates escitalopram is more effective than paroxetine and sertraline.
Fluoxetine. Fluoxetine has a high potential for drug interactions. More than other SSRIs, fluoxetine may come with short-term weight loss, anxiety and sleep disruption. However, it has fewer withdrawal symptoms than other SSRIs.
Paroxetine. Paroxetine has a high potential for drug interactions. It may have greater sedative effects than other SSRIs and interfere with sleep quality.
Sertraline. Unlike other SSRIs, higher doses of sertraline may have greater benefits. So, while you’ll start on a minimal dose, your healthcare provider may increase your dose amounts until you’ve reached maximum benefits. One meta-analysis showed sexual dysfunction effects with sertraline may be more dramatic than those experienced with escitalopram.
SSRIs may take time to start working, so don’t expect instant relief and results. Side effects are most common when you first begin taking the medicine or when you increase your dose, but for many people they typically fade with time. If the side effects you experience are intense or you’re considering stopping the medication, talk to your healthcare provider first.
Stopping SSRIs abruptly can lead to withdrawal effects like light-headedness, restlessness, headache and sleep disturbance.
Some medications and supplements (including St. John’s Wort) don’t mix well with SSRIs. Make sure you tell your prescribing healthcare provider about everything you take, so they can best evaluate potential drug interactions.